Pardee joins Mission Health Partners Accountable Care Organization

By CAITLIN BYRDTimes-News Staff Writer

Published: Thursday, July 24, 2014 at 1:15 p.m.

Last Modified: Thursday, July 24, 2014 at 1:15 p.m.

In an effort to attain the epitomized carrot of healthier patients and shared rewards under health care reform, Pardee Hospital announced Thursday that it will join the Mission Health Partners accountable care organization.

Pardee Chief Medical Officer Dr. Robert Kiskaddon said the decision could result in the Hendersonville-based hospital saving money in the next five to 10 years.

“For the first time in a very long time, this is a very patient-centered model that says we're going to reimburse providers for good outcomes. It's cheaper to keep patients well than to take care of them once they get sick,” he said. “With the overall goal to reduce the average cost per patient by using greater efficiency and keeping patients healthier, what Medicare will do is take the savings — the average cost of savings per patient — and redistribute it back to ACOs, which then redistribute it back to the hospitals.”

A key component in the cost-control efforts of the Affordable Care Act encouraged the creation of accountable care organizations, or ACOs. An ACO is a network of doctors and hospitals that shares both financial and medical responsibility for providing coordinated care to patients by focusing on reducing health care costs and improving quality of care provided.

Under the current fee-for-service model, Kiskaddon explained that physicians are rewarded for “every procedure, every hospital surgery and every wart removed.” In essence, the fee-for-service model rewards quantity rather than quality.

The ACO model turns the reimbursement structure upside down.

“In the old days, if I took really good care of a patient and decreased the cost (of taking care of the patient), their insurance company would save money. I wouldn't get any money for it,” Kiskaddon said. “With this coordinated system, the savings are returned to this accountable care organization's shared savings program to reinvest in higher quality, greater efficiency and lowering the costs of care.”

The Mission Health Partners ACO, which formed last month, contains about 200 primary care physicians, according to Mission Health officials. Kiskaddon said the ACO will cover more than 320,000 patients in Western North Carolina. Patients will not have to change providers.

Pardee spokesman Adam Fisher said the hospital will continue focusing its efforts on providing both quality care and quality follow-ups.

“We're going to be doing more care management, following up with patients after discharge,” he said.

According to a recent report from Leavitt Partners, a health care intelligence business, 626 ACOs have been identified in the United States as of May 2014.

Right now, the Mission Health Partners ACO is enrolling only primary care providers, including internal medicine, family practitioners and pediatricians. As time goes on, Kiskaddon said the organization will include more practitioners and medical specialties.

<p>In an effort to attain the epitomized carrot of healthier patients and shared rewards under health care reform, Pardee Hospital announced Thursday that it will join the Mission Health Partners accountable care organization. </p><p>Pardee Chief Medical Officer Dr. Robert Kiskaddon said the decision could result in the Hendersonville-based hospital saving money in the next five to 10 years.</p><p>“For the first time in a very long time, this is a very patient-centered model that says we're going to reimburse providers for good outcomes. It's cheaper to keep patients well than to take care of them once they get sick,” he said. “With the overall goal to reduce the average cost per patient by using greater efficiency and keeping patients healthier, what Medicare will do is take the savings — the average cost of savings per patient — and redistribute it back to ACOs, which then redistribute it back to the hospitals.” </p><p>A key component in the cost-control efforts of the Affordable Care Act encouraged the creation of accountable care organizations, or ACOs. An ACO is a network of doctors and hospitals that shares both financial and medical responsibility for providing coordinated care to patients by focusing on reducing health care costs and improving quality of care provided. </p><p>Under the current fee-for-service model, Kiskaddon explained that physicians are rewarded for “every procedure, every hospital surgery and every wart removed.” In essence, the fee-for-service model rewards quantity rather than quality. </p><p>The ACO model turns the reimbursement structure upside down.</p><p>“In the old days, if I took really good care of a patient and decreased the cost (of taking care of the patient), their insurance company would save money. I wouldn't get any money for it,” Kiskaddon said. “With this coordinated system, the savings are returned to this accountable care organization's shared savings program to reinvest in higher quality, greater efficiency and lowering the costs of care.”</p><p>The Mission Health Partners ACO, which formed last month, contains about 200 primary care physicians, according to Mission Health officials. Kiskaddon said the ACO will cover more than 320,000 patients in Western North Carolina. Patients will not have to change providers. </p><p>Pardee spokesman Adam Fisher said the hospital will continue focusing its efforts on providing both quality care and quality follow-ups. </p><p>“We're going to be doing more care management, following up with patients after discharge,” he said. </p><p>According to a recent report from Leavitt Partners, a health care intelligence business, 626 ACOs have been identified in the United States as of May 2014.</p><p>Right now, the Mission Health Partners ACO is enrolling only primary care providers, including internal medicine, family practitioners and pediatricians. As time goes on, Kiskaddon said the organization will include more practitioners and medical specialties.</p><p>“These things grow over time,” he said.</p><p>___</p><p>Reach Byrd at caitlin.byrd@blueridgenow.com or 828-694-7881.</p><p>___</p><p>Follow Caitlin Byrd on Twitter at https://twitter.com/MaryCaitlinByrd</p>